University Name

Date of Establishment
Address
Longitude Latitude
Web Address
Region (Based on region classification)
Rector / President / Vice Chancellor of University
Sustainability Director
Person in Charge
PIC/Sustainability Director e-mail address Rev. 15
Total Budget University per year
Partnership on Sustainability
a. Network:
1. Local (please specify) 2. Regional (please specify) 3. International (please specify)

b. Partner :
1. Government 2. Community 3. Educational Institution

No Points CRITERIA INDICATIVE PERFORMANCE MEASURE Evidence

1 1500 Setting and Infrastructure (SI)
[ 1 ] Comprehensive [ 2 ] Specialized
1.1. Type of higher education institution higher education
institution
[ 1 ] Tropical wet [ 2 ] Tropical wet [ 3 ] Semiarid [ 4 ] Arid [ 5 ] Mediterranean
and dry
1.2. Climate
[ 6 ] Humid [ 7 ] Marine west [ 8 ] Humid [ 9 ] Subarctic
subtropical coast continental
1.3. Number of campus sites Provide number Yes
1.4. Main Campus Setting [ 1 ] Rural [ 2 ] Suburban [ 3 ] Urban [ 4 ] In city center [ 5 ] High rise building Yes
2
1.5. Total main campus area (m ) Provide number Yes
Total main campus ground floor area of buildings
1.6. SI1 300 Provide number
(m 2)
1.7. Total main campus buildings area (m 2) Provide number
2
1.8. Total main campus smart building area (m ) Provide number
1.9. Total parking area (m 2) Provide number

1.10. SI3 200 Total area on campus covered in forest (%) Provide number

Total area on campus covered in planted vegetation

1.11. SI4 200 Provide number
(%)

Total area on campus for water absorption besides

1.12. SI5 300 Provide number
forest and planted vegetation (%)

1.13. Total number of students (part time and full time) Regular student Provide number Online student Provide number
SI2 300
1.14. Total number of academic and administrative staff Provide number

University budget for sustainability effort within a

1.15. SI6 200 Provide number
year (%)
No Points CRITERIA INDICATIVE PERFORMANCE MEASURE Evidence

2 2100 Energy and Climate Change (EC)

Energy efficient appliances usage are replacing [ 1 ] None [ 2 ] less than 20% [ 3 ] 20% - 40% [ 4 ] 40% - 60% [ 5 ] 60% - 80% [ 6 ] 80% - 100%
2.1. EC1 200 Yes
conventional appliances
[ 1 ] None [ 2 ] Program in [ 3 ] Program in [ 4 ] Implemented [ 5 ] Implemented [ 6 ] Implemented
preparation (e.g. initial in less than 30% of in between 30% - in more than 70%
Feasibility Study or implementation the total building 70% of the total of the total
2.2. EC2 300 Smart Building implementation Detailed Engineering (e.g. Builder area building area building area Yes
Design phase) already appointed)

[ 1 ] None
[ 2 ] Bio diesel Provide capacity in [ 5 ] Geothermal Provide capacity in
Kilo Watt Kilo Watt

[ 3 ] Clean biomass Provide capacity in [ 6 ] Wind power Provide capacity in

Kilo Watt Kilo Watt
2.3. EC3 300 Renewable energy produce on campus per year Yes
[ 7 ] Hydropower Provide capacity in
Kilo Watt

[ 4 ] Solar power Provide capacity in [ 8 ] Combine Heat Provide capacity in

Kilo Watt and Power Kilo Watt

2.4. EC4 300 Electricity usage per year (in kilo watt hour) Provide number Yes

Ratio of renewable energy produce/production [ 1 ] None [ 2 ] less than 20% [ 3 ] 20% - 40% [ 4 ] 40% - 60% [ 5 ] 60% - 80% [ 6 ] 80% - 100%
2.5. EC5 200
towards total energy usage per year
[ 1 ] None [ 2 ] Natural [ 3 ] Full natural [ 4 ] Existence of [ 5 ] Existence of
Elements of green building implementation as ventilation day-lighting building energy Green Building
2.6. EC6 300 manager Yes
reflected in all construction and renovation policy

[ 1 ] None [ 2 ] Program in [ 3 ] Program in [ 4 ] Implemented

preparation (e.g. initial in HVAC System /
Feasibility Study implementation Refrigerator /
2.7. EC7 200 Greenhouse gas emission reduction program and promotion) (e.g. initial Laboratory Gases Yes
measurement of
gas emission
reduction)
Please provide total carbon footprint (CO 2 emission Provide number
2.8. EC8 300 in the last 12 months, in metric tons) Yes

3 1800 Waste (WS)

[ 1 ] None [ 2 ] Double sided- [ 3 ] The use of [ 4 ] The use of [ 5 ] Print when
Program to reduce the use of paper and plastic in
3.1. WS1 300 printing policy tumbler reusable bag necessary Yes
campus
program
[ 1 ] None [ 2 ] Partial (less [3] Partial (25% - [ 4 ] Extensive
3.2. WS2 300 Recycling program for university waste than 25% of waste) 50% of waste) (more than 50%) Yes

[ 1 ] Not managed [ 2 ] Partly contained [ 3 ] Completely

and inventoried contained,
3.3. WS3 300 Toxic waste handled Yes
inventoried and
handled
No Points CRITERIA INDICATIVE PERFORMANCE MEASURE Evidence
[ 1 ] Open dumping [ 2 ] Partly [ 3 ] Partly [ 4 ] Fully [ 5 ] Fully
composted and composted and composted, composted,
3.4. WS4 300 Organic waste treatment compost dumped compost used compost used compost used Yes
internally and
externally
[ 1 ] Burned in open [ 2 ] Taken off [ 3 ] Partially [ 4 ] Fully recycled
3.5. WS5 300 Inorganic waste treatment campus to a dump recycled (less than (more than 50%) Yes
site 50%)
[ 1 ] Disposed [ 2 ] Treated [ 3 ] Centralized [ 4 ] Treatment for
3.6. WS6 300 Sewerage disposal untreated into individually in septic treatment before recycling Yes
waterways tank disposal
4 1000 Water (WR)
[ 1 ] None [ 2 ] Program in [ 3 ] Program in [ 4 ] Implemented [ 5 ] Implemented [ 6 ] Implemented
preparation (e.g. initial in Rain Harvesting in Ground Water in Lakes or Ponds
Feasibility Study implementation System Tanks
4.1. WR1 300 Water conservation program implementation and promotion) (e.g. initial Yes
measurement of
potential water
conserved)
[ 1 ] None [ 2 ] Program in [ 3 ] Program in [ 4 ] Recycled [ 5 ]Recycled water [ 6 ] Recycled
preparation (e.g. initial water is used for is used for toilet water is used for
Feasibility Study implementation garden sprinkler flushing the cooling
4.2. WR2 300 Water recycling program implementation and promotion) (e.g. initial systems system and/or car Yes
measurement of wash
potential water
recycle)
[ 1 ] None [ 2 ] Program in [ 3 ] Less than [ 4 ] 25%-50% [ 5 ] 50%-75% [ 6 ] More than
preparation (e.g. 25% water efficient water efficient water efficient 75% water
The use of water efficient appliances (water tap, toilet water efficient appliances appliances appliances efficient
4.3. WR3 200 appliances selection installed installed installed appliances Yes
flush, etc)
priority are
identified)
4.4. WR4 200 Piped water consumed Percentage
5 1800 Transportation (TR)
5.1. Number of cars owned by your university Provide number
5.2. Number of cars entering the university daily Provide number
TR1 200
5.3. Number of motorcycles entering the university daily Provide number
5.4. Number of shuttles operated in your university Provide number
5.5. TR2 200 Average number of passengers of each shuttle Provide number
5.6. Total trips of shuttle services each day Provide number
Provide number
5.7. TR3 200 Average number of bicycles on campus every day

[ 1 ] Open space or [ 2 ] Combination of [ 3 ] Building or [ 4 ] Parking is

5.8. TR4 200 Parking area type horizontal type open space and vertical space restricted Yes
building
 No Points CRITERIA INDICATIVE PERFORMANCE MEASURE Evidence
[ 1 ] None [ 2 ] Program in [ 3 ] Program [ 4 ] Program [ 5 ] Program
preparation (e.g. resulting in less resulting in resulting in more
Transportation program designed to limit or decrease feasibility study and than 10% decrease between 10% - 30% than 30% decrease
5.9. TR6 200 the parking area on campus over the last 3 years promotion) in parking decrease in in parking or
(from 2014 to 2016) parking parking is
restricted

[ 1 ] None [ 2 ] Charging high [ 3 ] Car sharing [ 4 ] Metro / tram / [ 5 ] Metro / tram /

Transportation initiatives to decrease private parking fees bus station on bus services
5.10. TR5 200
vehicles on campus campus inside campus
[ 1 ] Shuttle service is [ 2 ] Shuttle service [ 3 ] Shuttle
possible but not is available, but not service is
provided free available, and free.
5.11. TR7 300 Shuttle services Or shuttle use is Yes
not possible

[ 1 ] Bicycle and [ 2 ] Bicycle use is [ 3 ] Bicycle and [ 4 ] Bicycle and

pedestrian paths are not possible or pedestrian paths pedestrian paths
5.12. Bicycle and pedestrian policy on campus not available practical, but are available are available, and Yes
TR8 300 pedestrian paths are bicycles are
available provided freely by
A approximate daily travel distance of a vehicle Provide number the university
5.13. inside campus only (in Kilometers)
6 1800 Education (ED)
Number of courses/modules related to environment Provide number
6.1. and sustainability offerred Yes
ED1 300
6.2. Total number of courses/modules offered Provide number Yes
Total research funds dedicated to environmental and Provide number
6.3.
ED2 300 sustainability research (in US Dollars)
6.4. Total research funds (in US Dollars) Provide number Yes
Number of scholarly publications on environment Provide number
6.5. ED3 300
and sustainability published
Number of events related to environment and Provide number
6.6. ED4 300 sustainability Yes

Number of student organizations related to Provide number

6.7. ED5 300
environment and sustainability
Existence of a university-run sustainability website [ 1 ] Not available [ 2 ] In progress or [ 3 ] Available, http://
6.8. ED6 300
under construction
Note: Please refer to the 2017 Guideline for further information